The slow-footed federal response to Ebola shows that the United States would be overwhelmed by a biological attack, experts warn.
Ever since 9/11, security analysts have said it’s only a matter of time before terrorists acquire the means to attack the country with a bioweapon.
{mosads}While experts say Ebola would not make the most effective biological weapon, the problems seen in the response to the virus — from confusion over treatment protocols to a shortage of specialized medical facilities and trained workers — would be magnified if a biological agent were unleashed in the United States.
“We can see how easy it was to overwhelm one pretty good hospital in Dallas,” said retired Air Force Col. Randall Larsen, national security adviser at the University of Pittsburgh Medical Center (UPMC). “If this is a sign of how well we’re prepared for the big one, we’re in trouble.”
Experts say advancements in technology have made it easier than ever before for terrorists to develop biological weapons, with much of the equipment available on the Internet. Groups like al Qaeda have already shown their intent, Larsen said.
“Any reasonably well-funded terrorist organization can buy the capability to make a sophisticated bioweapon … so there’s great concern right now,” said Larsen, who is also a senior fellow at the Homeland Security Policy Institute at George Washington University.
Experts say the U.S. response to the three cases of Ebola show gaps in the country’s preparedness.
Federal agencies have struggled to put procedures in place for the proper treatment of Ebola patients. Under fire for the infection of two nurses at Texas Health Presbyterian Hospital, the government has vowed to send rapid-response teams to any hospital that discovers an Ebola case. On Sunday, Defense Secretary Chuck Hagel announced the creation of similar teams at the Pentagon.
In the event of a large-scale biological attack, the government’s challenges would be far greater, experts said.
Robert Garry, a microbiology professor at Tulane University with extensive experience in West Africa, said the Ebola cases have exposed gaps in communication.
“We learned that not all hospitals and healthcare facilities have up-to-date and appropriate information about Ebola and the possible threats that could cause for a healthcare facility or a community,” Garry said.
In the event of a large-scale biological attack, coordinating proper treatment protocols across federal, state and local agencies would be challenging, said Jeanne Ringel, director of the RAND Corporation’s population health program.
And although the U.S. has vaccines and antibiotics for small pox and anthrax, it lacks sufficient medical countermeasures for other agents, such as Tularemia and SEB.
“Our current policy makers have not taken seriously that issue, and we don’t have a strategy to deal with that kind of attack,” said retired Maj. Gen. Philip K. Russell, founding president and chairman of the Sabin Vaccine Institute.
“If we had an attack with those two agents, there’d be an enormous demand for a vaccine to protect the population against a second attack, and we don’t have those vaccines. We’re relying on antibiotics that don’t deal effectively with Tularemia or SEB,” he said.
Also, he said, “a strategic attack would overwhelm our hospital systems” in the areas affected.
“Most hospitals are running at a full capacity,” added Ringel.
The nurses who were infected with Ebola in Texas were eventually flown to medical facilities in Maryland and Georgia, highlighting the shortage of specialized facilities to deal with highly infectious diseases.
“The stress on the system that has been induced by Ebola has shown we still have a lot of work to do, and we’re not at the place that we need to be,” said Dr. Tom Inglesby, CEO and director of UPMC. “A larger event would be challenging no matter what the pathogen and toxin.”
Still, experts say the U.S. is much better prepared for a biological attack than it was in 2001.
“There’s been a lot of investment and work and effort put into developing systems and training people and building capabilities to address these types of threats since then, and it certainly has improved our preparedness,” Ringel said.
Laura Holgate, the White House’s senior director for weapons of mass destruction, terrorism and threat reduction, spoke recently about the methods a terrorist could use to attack with a biological agent.
She said a person could infect themselves with a virus and get on a plane, spray one in the air at a large public event, or even inject someone with a syringe, but she said there were a number of barriers to pulling off such an attack.
“The person designing this has to understand the details of the disease in order for any of these to be effective, and then have the ability to weaponize it, or to gain access to material that is of the appropriate purity — in the case of anthrax, the appropriate physical consistency,” she said at an Oct. 1 conference in Washington.
“The aerosolization is a very big challenge, particularly for terrorist institutions and lone wolves, so there’s … fortunately a lot of barriers to this,” she said. “But we can always do better.
Larsen said the Obama administration needs a single person in charge of the nation’s biodefenses, as there was under the Clinton and second Bush administrations.
“Today, there are more than two dozen presidentially appointed, Senate-confirmed individuals with some responsibility for biodefense, but no one is in charge, and no one even has it as a full-time job,” he said.
The White House has already moved to centralize the Ebola response, on Friday appointing Ron Klain, a Democratic operative, to oversee the effort.
Larsen said more money needs to be spent on developing medical countermeasures, such as vaccines, and warned that the threat from viruses will not go away — whether from a bioweapons attack or from “Mother Nature.”
“We’re seeing every decade a dozen new diseases that we’ve not even seen before,” he said. “We’re going to see more of that and we need to understand that public health is an critical part of our national security.”
Larsen, who served as the executive director of the bipartisan, congressionally appointed Weapons of Mass Destruction Commission, said it’s worrisome that the Ebola cases in Dallas have proved to be such a challenge for health officials.
“We thought, based on our assessment, that America would do reasonably well to a small-scale event, but so far, [Ebola] is so much smaller than what our small-scale scenario was, and we certainly seem to be stumbling coming out of the gates,” he said.
Larsen and other members of the WMD Commission, including former Sens. Bob Graham (D-Fla.) and Jim Talent (R-Mo.), warned years ago that the primary means of defending America against bio-terrorism would be “the capability to effectively respond after an attack has occurred.”
On a 2011 report card, they graded U.S.’s preparedness for a large-scale outbreak with C’s, D’s and F’s, and Larsen said not much has changed since then.
Absent a real attack, Ringel said it’s difficult to say how well the country would respond.
“We do a lot of planning, and a lot of exercises. … You’re never able to fully replicate what’s happening in an event,” she said.